Emergency Physicians’ Knowledge and Provision of Child Passenger Safety Information

Authors

  • Mark R. Zonfrillo MD, MSCE,

    1. From the Division of Emergency Medicine (MRZ, KAN, DRD) and the Center for Injury Research and Prevention (MRZ, DRD), Children’s Hospital of Philadelphia, Philadelphia, PA; and the Department of Pediatrics, University of Pennsylvania School of Medicine (MRZ, KAN, DRD), Philadelphia, PA.
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  • Kyle A. Nelson MD, MPH,

    1. From the Division of Emergency Medicine (MRZ, KAN, DRD) and the Center for Injury Research and Prevention (MRZ, DRD), Children’s Hospital of Philadelphia, Philadelphia, PA; and the Department of Pediatrics, University of Pennsylvania School of Medicine (MRZ, KAN, DRD), Philadelphia, PA.
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  • Dennis R. Durbin MD, MSCE

    1. From the Division of Emergency Medicine (MRZ, KAN, DRD) and the Center for Injury Research and Prevention (MRZ, DRD), Children’s Hospital of Philadelphia, Philadelphia, PA; and the Department of Pediatrics, University of Pennsylvania School of Medicine (MRZ, KAN, DRD), Philadelphia, PA.
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  • This work was presented in part at the 2009 American Academy of Pediatrics National Conference and Exhibition, at which Dr. Zonfrillo was awarded the Best Trainee Abstract at the Section on Injury, Violence and Poison Prevention.

  • The authors have no relevant financial information or conflicts of interest to disclose.

  • Supervising Editor: Michael J. Mello, MD, MPH.

Address for correspondence and reprints: Mark R. Zonfrillo, MD, MSCE; e-mail: zonfrillo@email.chop.edu.

Abstract

ACADEMIC EMERGENCY MEDICINE 2011; 18:145–151 © 2011 by the Society for Academic Emergency Medicine

Abstract

Objectives:  While physicians provide discharge instructions to patients and families following emergency department (ED) visits, injury prevention information may not be routinely included in these instructions. This study assessed emergency physicians’ knowledge and provision of child passenger safety (CPS) information to patients following motor vehicle crashes (MVCs).

Methods:  This study was both a survey of emergency physician knowledge and provision of CPS information and an examination of frequency of CPS information in discharge instructions at a single institution. Members of the American Academy of Pediatrics (AAP) Section on Emergency Medicine were invited to participate in the survey. Respondents were asked about their provision of CPS information to patients and knowledge of national AAP CPS recommendations. The institutional ED medical record chart review assessed the frequency of written CPS information for patients of MVC-related visits who were discharged home.

Results:  There were 317 survey respondents from 1,024 eligible physicians, of whom 43 began but did not complete the survey. The data analyzed are from the 274 who completed the survey. While 85% (95% confidence interval [CI] = 81% to 89%) of physicians believed that CPS information should be included in discharge instructions, only 36% (95% CI = 31% to 42%) correctly answered all knowledge questions. Of the 51 self-identified division/department chiefs, 15 (29.4%; 95% CI = 16.9% to 41.9%) reported that their EDs routinely provide CPS information in discharge instructions for pediatric passengers in MVCs. For the medical record review, of the 152 randomly selected MVC visits, 13 (8.6%; 95% CI = 4.1% to 13.0%) had documented CPS information in the discharge instructions. Patients with documented CPS information were younger, but there were no significant differences in race, sex, or maximum abbreviated injury scale score between patients with versus without CPS information.

Conclusions:  While emergency physicians value the use of CPS information in discharge instructions following MVCs, they do not have adequate knowledge of, nor do they regularly disseminate, this information.

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